Executive order challenges Obamacare, impact on ND farmers uncertain

Oct. 13--President Donald Trump issued an executive order on Thursday to strip away some regulations requiring association health plans (AHP), groups of small businesses and individuals that band together to purchase health insurance.

The order is still subject to a public hearing process and is not expected to directly impact insurance plans for the upcoming Affordable Care Act, also known as Obamacare, enrollment period beginning on Nov. 1, but experts believe that it could represent a major change to the nation's health care industry.

The order is entitled "Promoting Healthcare Choice and Competition Across the United States" and Trump said it will mean greater choice and cheaper healthcare options for Americans.

Critics argue that the AHP's would provide poor coverage for consumers and threaten the long-term viability of Obamacare exchange markets, as it would potentially draw healthier enrollees away from Obamacare to AHP's through directives such as eliminating the need to cover essential health benefits and encouraging the purchase of health insurance across state lines.

On Thursday, North Dakota Gov. Doug Burgum and Insurance Commissioner Jon Godfread issued a joint statement in support of the plan. The statement argues that the order provides relief for the "three most serious problems of Obamacare," which they point to as a lack of variety and access to healthcare, a decline in small businesses offering health insurance to employees and limited options for lower cost healthcare plans.

"Obamacare has caused serious harm to small businesses and to working individuals who make too much money to receive a federal subsidy," Godfread said. "I'm pleased that the President has continued to look for ways in which the federal government can provide relief to consumers."

North Dakota's Republican representatives in Congress, Sen. John Hoeven, R-N.D. and Rep. Kevin Cramer, R-N.D., also issued statements in support of the executive order.

"Given the Senate's unwillingness to repeal and replace Obamacare, I greatly appreciate President Trump's decisive actions," Cramer said. "It's the least we can do until another U.S. Senator decides to put the interests of the American people first by voting to fix our collapsing health care system."

Striking a similar tone, Hoeven said, "today's order provides regulatory relief to bring down premiums for workers and employers and will help expand access to more affordable health insurance options."

Many congressional Democrats quickly denounced the measure as a means to sabotage Obamacare that would come at the expense of millions of older and less healthy Americans.

In a statement, Sen. Heidi Heitkamp, D-N.D., did not come out immediately for or against the measure.

"This new executive order will have to be examined to see if it will improve affordability and access to care," she said, "(but) the administration should take steps to immediately provide certainty in the health care marketplaces and lower premiums for consumers."

North Dakota Democratic congressional candidate Ben Hanson came out strongly against the measure.

"This (executive order) lets insurance companies offer plans with fewer protections for patients and fewer actual benefits," he said. "I can't imagine patients across North Dakota will 'greatly appreciate' paying more for less coverage with fewer protections."

The order also specifically points out farmers as people who stand to benefit from the plan and a few weeks ago, Cramer said that he believes that more association health plans would help farmers.

"We should allow more association formation and farmers are a good group to do that with," Cramer said, "we should be able to offer a more flexible form of insurance where they can purchase what they need rather than what the government tells them."

President of the North Dakota Farmers Union Mark Watne said that he needs more time to examine how the order could impact farmers in North Dakota but he was wary of claims that this was an order geared to specifically help out farmers.

"I really don't believe there was a big urgency push from farmers to get this done" he said, "there is urgency from farmers to have a better health insurance plan that would enable them to get better coverage at a more reasonable cost."

Watne argued that when it comes to health insurance farmers in North Dakota face complex challenges that can be difficult to address.

"The main issue for farmers is that they're considered high risk and there are lots of accidents" Watne said, "typically they have to take somebody off the farm for work to pay for health insurance."

Watne said that more farmers have been able to get insurance through ACA but he still thinks that far too many farmers do not have insurance or have been priced out of coverage by high premiums. Watne said he is open to either enhancing the ACA or providing more freedom to farmers to pool together their health plans as long as it would make life better for North Dakota farmers, no matter what party the healthcare plan comes from.

"I'm hopeful because anything we can do to enhance the Affordable Care act or to figure out how to do better in health insurance would be a good thing."

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